Evolution and current challenges of laparoscopic cholecystectomy
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摘要:
腹腔镜胆囊切除术(LC)问世二十多年来,已成为国际上公认的胆囊切除的金标准术式。随着微创外科概念和腹腔镜-内镜技术的迅速发展,近年来腹壁无瘢痕手术引起外科界的关注。本文对于经脐单孔腹腔镜胆囊切除术的手术器械、操作技术进行探讨,希望通过改进其手术操作的方便性及安全性,提高其普及应用的可行性。
Abstract:Since its introduction at the end of the 20th century, laparoscopic cholecystectomy has evolved into a safe and convenient minimally invasive surgical method, which is now the gold standard therapy for cholelithiasis worldwide.Physicians have continued to improve upon the procedure, creating methods that further minimize the related scarring and pain, such as the laproendoscopic single-site cholecystectomy and the gasless-lift laparoscopy.Additionally, the primary challenge of limited operative space in these procedures remains a key feature requiring improvement.In this review, the development and progression of laparoscopic cholecystectomy over the past 26 years is discussed, highlighting the current advantages and disadvantages that need to be addressed by practicing physicians to maximize the clinical value of this important therapy.
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Key words:
- cholecystectomy /
- laparoscopic
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[1]刘国礼.我国腹腔镜外科的现状—156820例腹腔镜手术综合报告[J].中华普通外科杂志, 2001, 16 (10) :562-564. [2]徐大华.腹腔镜胆囊切除术的基本应用原则和进展[J].医学临床研究杂志, 2005, 22 (10) :1360-1362. [3] Navarra G, Pozza E, Occhionorelli S, et al.One-wound laparoscopiccholecystectomy[J].Br J Surg, 1997, 84 (5) :695. [4]Podolsky ER, CurcilloⅡPG, Rottman SJ, et al.Single port ac-cess (SPA) surgery-initial experience of a novelminimal access ap-proach applied across surgical specialties[J].Surg Endosc, 2008, 22 (Suppl) :s172. [5]徐大华.从微创外科技术应用纵观微创外科理念发展[J].中国微创外科杂志, 2011, 11 (2) :102-103. [6]中华医学会外科学分会腹腔镜-内镜外科学组.单孔腔镜手术技术专家共识[J].中国实用外科杂志, 2010, 30 (8) :665-666. [7]Zhang GY, Hu SY, Li F.The application of transumbilical singleport laparoscopic cholecystectomy[J].J Laparo Surg, 2009, 14 (1) :18-20. (in Chinese) 张光永, 胡三元, 李峰.经脐单孔腹腔镜胆囊切除术[J].腹腔镜外科杂志, 2009, 14 (1) :18-20. [8]张忠涛, 韩威, 李建设, 等.经脐单孔腹腔镜胆囊切除术1例报告[J].腹腔镜外科杂志, 2008, 13 (4) :314. [9]郑民华.腔镜手术在普外科的应用与发展趋势[J].中国微创外科杂志, 2010, 10 (12) :1057-1059. [10]徐大华.单孔腹腔镜手术的技术瓶颈分析[J].中国微创外科杂志, 2010, 10 (1) :21-32. [11]徐大华.单孔腹腔镜手术器械的研发与应用[J].腹腔镜外科杂志, 2010, 15 (1) :3-5. [12]Nagai H.A new method of laparoscopic cholecystectomy:An ab-dominal wall lifting technique without pneumoperitoneum[J].SurgLaparosc Endosc, 1991, 1 (2) :126. [13]Xu DH.The opportunity, challenge and consideration of the mini-mally invasive surgical times[J].Chin J Hepatobiliary Surg, 2011, 17 (8) :603-605. (in Chinese) 徐大华.微创外科时代的机遇、挑战和思考[J].中华肝胆外科杂志, 2011, 17 (8) :603-605.
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